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Intensive Behavioral Interventions - Cigna

Medical Coverage Policy Effective Date ..12/15/2019. Next Review Coverage Policy Number .. 0499. Intensive Behavioral Interventions Table of Contents Related Coverage Resources Overview .. 1 Attention-Deficit/Hyperactivity Disorder (ADHD): Coverage Assessment and Treatment General Background ..3 Autism Spectrum Disorders/Pervasive Developmental Coding/Billing Information ..10 Disorders: Assessment and Treatment References ..11. INSTRUCTIONS FOR USE. The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies.

Diagnostic and Statistical Manual of Mental Dis orders, Fifth Edition (DSM-5) A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, no exhaustive; see text of DSM-5) 1.

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